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Age related differences in balance approached by a novel dual-task test of anticipatory postural control strategies.

ABSTRACT: INTRODUCTION:Assessment of balance is key to identifying individuals with postural control deficits and an increased fall risk. Subjects may compensate for their deficits by utilizing other strategies; to avoid this, it is recommended to assess postural control using a dual-task test. In most dual-task tests, it is difficult to monitor the performance in the secondary task and the individual's task prioritisation. This study evaluated a new dual-task testing approach. MATERIALS AND METHODS:A convenience sample of 54 community-dwelling elderly (age 65+ years) and a reference group of 20 young participants were included in the study. They performed a test in which they could utilize cues to improve their baseline performance, provided their level of postural control allowed them residual attention capacity for this cognitive task. RESULTS:Significant performance differences were seen between the young and the elderly. The young group improved their performance time by 23.9% (10.7) and 7.1% (14.2) with a cue and a reverse cue, respectively, whereas the elderly failed to improve their performance time. The test was unable to distinguish between individuals within the elderly group due to a floor effect. DISCUSSION:The test reveals an individual's capacity to use cues for anticipatory postural control strategies in a dual-task setting and thereby estimates automatization of postural control. While the young subjects were capable of improving their performance during dual-task conditions, the elderly subjects apparently had no residual attentional capacity allowing them to utilize the facilitating cues. Within the elderly group, the dual-task aspects of the test added no value with respect to differentiation in the level of postural control.

SUBMITTER: Laessoe U

PROVIDER: S-EPMC6597154 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Age related differences in balance approached by a novel dual-task test of anticipatory postural control strategies.

Laessoe Uffe U Larsen Camilla Bille CB Schunck Line Noerkjaer LN Lehmann Line Jensen LJ Iversen Halla H

PloS one 20190627 6

<h4>Introduction</h4>Assessment of balance is key to identifying individuals with postural control deficits and an increased fall risk. Subjects may compensate for their deficits by utilizing other strategies; to avoid this, it is recommended to assess postural control using a dual-task test. In most dual-task tests, it is difficult to monitor the performance in the secondary task and the individual's task prioritisation. This study evaluated a new dual-task testing approach.<h4>Materials and me ...[more]

PMID: 31246971

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Project description:Dual-task performance assessments of competing parallel tasks and postural outcomes are growing in importance for geriatricians, as it is associated with predicting fall risk in older adults. This study aims to evaluate the postural stability during different dual-task conditions including visual (SMBT), verbal (CBAT) and cognitive (MAT) tasks in comparison with the standard Romberg's open eyes position (OE). Furthermore, these conditions were investigated in a sample of young adults and a group of older healthy subjects to examine a potential interaction between type of secondary task and age status. To compare these groups across the four conditions, a within-between mixed model ANOVA was applied. Thus, a stabilometric platform has been used to measure center of pressure velocity (CoPV), sway area (SA), antero-posterior (AP) and medio-lateral (ML) oscillations as extents of postural sway. Tests of within-subjects effects indicated that different four conditions influenced the static balance for CoPV (p < 0.001), SA (p < 0.001). Post-hoc analyses indicated that CBAT task induced the worst balance condition on CoPV and resulted in significantly worse scores than OE (-11.4%; p < 0.05), SMBT (-17.8%; p < 0.01) and MAT (-17.8%; p < 0.01) conditions; the largest SA was found in OE, and it was statistically larger than SMBT (-27.0%; p < 0.01) and MAT (-23.1%; p < 0.01). The between-subjects analysis indicated a general lower balance control in the group of elderly subjects (CoPV p < 0.001, SA p < 0.002), while, the mixed model ANOVA did not detect any interaction effect between types of secondary task and groups in any parameters (CoPV p = 0.154, SA p = 0.125). Postural sway during dual-task assessments was also found to decrease with advancing age, however, no interactions between aging and types of secondary tasks were found. Overall, these results indicated that the secondary task which most influenced the length of sway path, as measured by postural stability was a simple verbal assignment.

Project description:BackgroundPersistent postural-perceptual dizziness (PPPD) is a newly defined disorder characterized by functional dizziness. Due to its recent discovery, definitive treatment for PPPD has not been established; therefore, this study aimed to assess the effectiveness of virtual reality (VR)-guided, dual-task, trunk balance training for the management of PPPD using the mediVR KAGURA system.MethodsWe analyzed data of patients who presented with PPPD from January 1, 2021, to February 28, 2021. The VR group included patients who underwent mediVR KAGURA-guided training for 100 tasks (10 min). Patients with PPPD who received standard treatment and rehabilitation were assigned to the control group. Equilibrium tests were performed at baseline and immediately after mediVR KAGURA-guided training to examine its effectiveness in improving static and dynamic balance. Additionally, clinical questionnaires related to balance disorders were administered at baseline and 1 week after mediVR KAGURA-guided training to examine its effects on balance-related symptoms. The primary outcome was improvements in static and dynamic balance and Niigata PPPD Questionnaire (NPQ) scores.ResultsVR-guided training using mediVR KAGURA improved objective outcomes, including static and dynamic postural stability, after a single 10-min training session. Additionally, mediVR KAGURA-guided training improved scores on the Hospital Anxiety and Depression Scale and NPQ 1 week after the 10-min training session.ConclusionVR-guided training using mediVR KAGURA represents a viable method for managing balancing ability, anxiety, and symptoms in patients with PPPD. Such training provides a safe and cost-effective solution for PPPD management. Further studies are required to evaluate the clinical efficacy of this strategy.Trial registrationInstitutional Ethics Committee of Kitano Hospital, approval number: 1911003. Registered 18 December 2019, https://kitano.bvits.com/rinri/publish_document.aspx?ID=426 .

Dataset Information

Age related differences in balance approached by a novel dual-task test of anticipatory postural control strategies.

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Age related differences in balance approached by a novel dual-task test of anticipatory postural control strategies.

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